AIN Blog: Torqued: FAA Must Get Its Act Together on ADs

How accurate should airworthiness directives be? Before you answer that question, let me give you an example of an actual AD applicable to the Airbus A318/319/320/321 and then you can decide whether the information provided is sufficient for a mechanic to perform the required maintenance properly. I know you’re not all mechanics, but I don’t think you need to be one to see the problem. And if you fly or maintain GA aircraft, and think this issue doesn’t apply to you, think again. If the FAA doesn’t scrutinize ADs for large aircraft that carry millions of people around the world, just how much scrutiny do you think it’s giving ADs applicable to GA aircraft?

As you all know, airworthiness directives are issued only when a known safety problem exists and that problem is likely to exist or develop in other similar products. To quote the regulation exactly, FAR 39.3 states, “The FAA issues an airworthiness directive addressing a product when we find that: (a) an unsafe condition exists in the product; and (b) the condition is likely to exist or develop in other products of the same type design.”

This means that the safety problem isn’t a speculative one. It’s not a potential safety problem. A safety problem actually exists that the FAA determines must be addressed by a rule, which becomes mandatory for anyone operating the product to which the AD applies. ADs are federal aviation regulations, and mechanics performing maintenance are required to comply with the requirements of the ADs, usually by performing required inspections or repairs.

The AD for the Airbus models, 2004-13-06, requires repetitive inspections to detect cracks in the keel beam side panels and make repairs if necessary. Keel beams support the structural integrity of the fuselage. The AD was issued “to detect and correct fatigue cracks on the side panels of the keel beams, which could result in reduced structural integrity of the airplane. This action is intended to address the identified unsafe condition.” The point of all this is that ADs in general, and this one in particular, are issued to address serious unsafe conditions. Reduced structural integrity of an airplane is clearly a serious safety issue.

Since ADs address serious, unsafe conditions, it seems obvious that the maintenance procedures developed to communicate what a mechanic has to do need to be as clear and as accurate as possible so that a serious unsafe condition can be found and addressed before an accident or incident results, with injuries or deaths. There should be no argument on this, right?

Ambiguous and Incorrect Directions

The recent emergency revocation of two mechanics’ certificates (which they won on appeal to the full NTSB on timeliness grounds) involves their alleged failure to comply with this very AD. In brief, the FAA discovered the alleged violations in January 2010. Notwithstanding how serious the FAA claimed the violations to be in January 2013, the agency allowed the mechanics to continue to perform maintenance on dozens of airliners carrying hundreds of thousands of passengers for three years without recalling or re-inspecting a single aircraft. It’s almost incredible to think that, if the FAA believed the violations were so serious, it would have waited three years to bring an emergency revocation, knowing that the mechanics were continuing to work on airliners that whole time. And, what’s more, how could the FAA determine that the mechanics could no longer be trusted to perform maintenance properly in 2013 and yet never check a single one of the dozens of aircraft the mechanics worked on in those intervening three years between when the violations were allegedly discovered and when the emergency order was issued? I digress. Makes the IRS look competent by comparison.

Ultimately on appeal to the full NTSB, the mechanics prevailed; the full Board determined that the FAA’s action was untimely. The NTSB found that the mechanics had been prejudiced by the inordinate amount of time that had passed and were unable to properly defend themselves because of that lapse of time. (Note: I was an expert witness for the mechanics.) Because the NTSB dismissed the cases on timeliness grounds (“laches” in legalese), the full Board never addressed the issues regarding the validity of the AD on appeal. So here are the technical issues related to the accuracy of the AD the mechanics were supposed to comply with.

The AD incorporates by reference Airbus’s Service Bulletin, which requires, among other steps, removal of a pump and accumulator and a “detailed visual inspection of the area around the rivets” for cracks. The mechanics are alleged not to have removed the pump and accumulator and the FAA thereby claimed the required inspection could not be done without these components being removed.

So here is the first accuracy issue with the AD: it requires–via the Airbus Service Bulletin that’s incorporated by reference–that the pump be removed first and then the accumulator. Once the inspection is completed, it requires the pump to be re-installed followed by the accumulator. It doesn’t take a mechanic to figure out that there’s something wrong with these directions: when removal of parts is done sequentially, their re-installation is also done sequentially but in the reverse order. So if the pump were removed first, for example, it would normally be re-installed last. In this case, if the steps were followed as required by the AD, they could be accomplished but it would take significantly longer than removing the accumulator first and then the pump, and then reinstalling the pump and then the accumulator. According to the FAA, sequential steps in an AD must be followed sequentially even if the outcome, as in this case, is absurd.

But, regardless of the order in which these components are to be removed, the FAA contended that the detailed visual inspection of the “area around the rivets” for cracks required by the AD could not have been accomplished without removal of those components. Without going into whether an inspection of the area under those components could be done without their removal, the issue here is that there are no rivets (as the term is defined by Airbus in its manuals, which are the manuals that apply to this AD) under these components. If there are no rivets, then mechanics can’t inspect for cracks around them–with or without the components removed.

So there’s the second accuracy issue: while there are no rivets under these components, there are fasteners–Hi-Lok pin fasteners to be specific–and it could be that Airbus in its Service Bulletin meant for the mechanics to inspect for cracks in the area around the fasteners. Maybe that’s what the FAA meant when it issued the AD. Maybe not. Maybe the rivets are somewhere else on the keel beam. Maybe they’re under different components. But are mechanics supposed to guess? Are mechanics’ licenses subject to revocation if they fail to conclude that Airbus meant “fastener” when what was written was “rivet” even when Airbus’s own manual differentiates between fasteners and rivets? According to Airbus’s manual, all rivets are fasteners but not all fasteners are rivets.

It seems that if Airworthiness Directives are issued to address known unsafe conditions, mechanics are entitled to the most accurate paperwork possible. And they certainly shouldn’t be subject to revocation when the paperwork is inaccurate. According to the FAA’s deposition of an airline mechanic not involved in these enforcement actions, this mechanic submitted a request to the airline years before these violations allegedly occurred, requesting a correction of the job cards used to comply with the AD to change the sequence in which components were removed because the order was clearly incorrect. To date no change in the sequence has been made by the airline, Airbus or the FAA.

So while I’m not aware that the rivet versus fastener issue was raised to the FAA or the airline before these alleged violations occurred, it has been raised at least since the NTSB hearing in February this year. As I write, no change to the AD has been made.

System Failure at the FAA

If you’re thinking this is one case, with one inspector or one FAA office not doing their jobs, it’s not. The problem is all the way up the chain of command at the FAA. (I won’t begin to speculate on how this Service Bulletin escaped Airbus’s quality control.) First, you have the FAA incorporating by reference an Airbus Service Bulletin into an AD without apparently ever checking if the Service Bulletin makes sense. Then you have emergency orders based on this AD used to revoke airmen certificates without anyone checking the AD for accuracy. And those emergency orders are cleared through Flight Standards management in the field, Flight Standards and legal management in the region and the highest levels of Flight Standards and legal in Washington, D.C. So you really have two broken systems at the FAA: the issuance of airworthiness directives and the issuance of emergency orders.

If you believe the mechanics should have refused to sign off the work until they were handed correct maintenance procedures, I totally agree. But in the real world, that’s not happening. If mechanics did that, aviation would grind to a halt. That’s how common paperwork problems are in maintenance. (In fact, one union official told me recently that when mechanics insist on accurate paperwork to sign off maintenance, the airlines treat it as a job action.) This particular AD was issued in 2004 and there are hundreds of these aircraft in the U.S. fleet that have been subject to these repetitive inspections. I know other mechanics have noted the inaccuracies but just created their own workarounds. This clearly puts their certificates at risk if the FAA finds out. But the bigger question is: do the workarounds all address the unsafe condition the AD was meant to detect?

The FAA knows it’s a problem; the FAAst Team issued a bulletin in January 2011 titled Incorrect Maintenance Manual Procedures. The first line is: “How many times have you done a job and realized the maintenance manual was incomplete or incorrect?” Mechanics don’t typically report paperwork problems at least in part because so many maintenance procedures are incorrect and mechanics are used to developing their own workarounds to get the job done. The airlines know incorrect procedures are common and tacitly, if not explicitly, condone the workarounds in the name of on-time departures. The manufacturers know there are problems because the maintenance procedures are not fully vetted by mechanics before they’re distributed.

This AD is but one example, the tip of an iceberg. But fixing the problem of incorrect maintenance paperwork has to start somewhere. FAA? Airbus?

Comments

Dr Jack A. Milavic (not verified)

July 1, 2013 - 11:58am

Upsetting to learn the FAA has again lowered it's standards for another certification process. In the past years the FAA has downplayed its interest in high standards of certification for pilots, mechanics and airplanes. The principal organization within the FAA for ensuring safety and standardization of all aircraft movements is Flight Standards. Because of current FAA philosophy to reduce quality of training and support for all Flight Standards we can expect to witness even more lower standards in the future.

Airline maintenance is a harsh business and the mechanic is between the proverbial “rock and a hard place”. I have experienced this myself where workarounds are the standard and tacitly approved by management by turning a blind eye. If we followed the philosophy of the Toyota Production Method where anyone can stop the production line if a fault is found you are correct the airlines would grind to a halt and management would see it as a job action. I approached several FAA inspectors and one high FAA official with the scenario of a mechanic being pressured to perform maintenance outside the scope of the regulations. This doesn’t have to be a direct threat but an implied one, but it is still pressuring the mechanic. The FAA considers this a management issue and would go after the mechanic.

So which path would an airline mechanic take, cave to management pressure and risk discovery by the FAA or refuse to bend under management pressure and risk getting terminated? Most will choose to bend under management pressure because we are naturally risk averse. The probability of the FAA discovery is minimal to the higher probability of management retaliation. There is one caveat; this decision is weighted by the severity of the potential safety issue. In this case I can see a mechanic would workaround removal of the components if the required inspection could be accomplished with those components in place. This would expedite the task but violate the AD. The intent is a thorough and safe inspection and in the mechanics eye this can be accomplished. I doubt there would be many mechanics that would simply disregard the AD completely and sign it off as accomplished. However, as an ex-Eastern Airlines mechanic I have seen this occur, unfortunately.

Very interesting article. Do mechancis use workarounds? Of course they do. Why? Because the responsible party does not perform its regulatory duty. So who is responsible for all this? FAA, A&P Mechanic, Airbus, or the certificated Air Carreir.

First the individual preforming this inspection is not required by the CFR's to have a A&P certificate to do so. If this is the case who is preforming the maintenance?

Answer: The Certificated Aircarrier is the maintenance enity, and is responsible to ensure that all maintenance is preformed in accordance with its manual. In this case the manual is written poorly and the aircarrier is not ensuring that it is used all the time.

If the FAA wants to ensure that manuals are written so mechanics can follow them and actually accomplish the proper maintenance, they should focus on the responsible party and stop wasting time on the person that has no authority to change the manual or ensure that it is followed.

Until the FAA and the NTSB put the focus on the actual responsible party nothing will change.

I am a retired A&P mechanic/lead and have been retired 7 years with over 60 year experience (and a Taylor Award to boot). On the subject of accurate ADs and manuals, I personally have in my 60 years submitted in writing over 300 manual and work card discrepancies and many more verbally. It took months or more to see the revisions. Most mechanics see these problems, but to get the job done and the plane back in service, they do what they think should have been written and sign it off. When company assigned inspectors were involved, many times there would be heated arguments over the subject. FAA field inspectors' duties and their competence are another subject that needs to be address.

I'm a Mechanic with 36 years of experience under my belt in different segments of aviation maintenance, GA, Airline Maintenance and FAA Certified 145 Repair Station. Every single day we have to put our certificate on line, pracitally we face double edge sword, the regulations and the management.
We mechanics are held responsible for every single action, because mechanics are directly accountable to FFA, no matter it's Management error, Manufacturer's error or FAA error.
I am personally thankfull to Mr. John Goglia for his advocacy for mechanics at all levels and look forward for broader support from our peers and industry.

Thanks John for bringing this to light. Mechanics who bring stuff like this to light are often treated as troublemakers and targeted by management. Other mechanics see this and avoid reporting errors in the paperwork and do workarounds just to try and stay out of trouble. Management is there everyday, the FAA isnt.

Whats even worse is that there have been times where the Courts have ordered mechanics to continue to do workarounds and not follow the book, or stop when the directions are unclear or wrong. In one case out of New York in 2000 (?) the Judge issued a TRO that actually instructed mechanics to not work by the book or do anything that would impede the operation.